Purpose: :
The OPI 2.0 system is comprised of a number of tear film analysistechnologies developed in an effort to better understand tearfilm and blink dynamics under natural conditions. A key featureof the system is the ability to look at tear film break up andresulting corneal surface exposure during various blink patterns.We hypothesize that dry eye subjects have largely variable blinkpatterns vacillating between periods of rapid blinks (when theeye compensates for an insufficient tear film) and periods whenblink rate slows. These periods of slower blink rates may becaused by environmental conditions, visual tasking or simplya lack in remaining compensatory capability. This study examineda population of dry eye subjects to determine if certain blinkpatterns yielded higher amounts of corneal exposure using theOPI 2.0 system.

Methods: :
Thirty one adult subjects with a history of mild to moderatedry eye completed the study. Tear film break up time, inter-blinkintervals (IBIs), and tear film break up area were recordedat baseline using the OPI 2.0 System. Subgroups were also evaluatedbased on tear film break up time.

Results: :
Break up area was significantly greater in subjects with longerIBIs (periods of slower blink rates) than those with shorterIBIs (rapid compensatory blinking patterns. p<0.05). Subjectswith faster break up times showed greater ocular surface exposurewith increasing IBIs compared to those with slower break uptimes (p=0.031).

Conclusions: :
This study comprehensively relates the relationship betweentear film break up time, blink pattern, and total ocular surfaceexposure. Subjects with longer IBIs and shorter TFBUTs demonstratedhigher levels of ocular surface exposure. Furthermore, the resultsof this study support the concept that rapid blink patternscan function as a compensatory mechanism for tear film deficiency,while a period of slower blink rates in this blink pattern (yieldinglonger IBIs) results in increased ocular surface exposure andpresumably heightened ocular surface inflammation.